Denim sandblasters’ pneumoconiosis

A 28-year-old man with long standing dyspnea for 4 years and a history of dry cough, sweating and loss of weight was admitted to the hospital. Physical examination showed fine crackles at the end of inspiration. The laboratory tests revealed increased low density lipoprotein level with slight increase in erytrocyte sedimentation rate. Sputum smears for blood culture and tuberculosis were negative. He was referred to the radiology department for imaging studies. Chest radiography revealed bilateral reticulonodular infiltrates in upper and middle zones. High resolution computed tomography showed bilateral diffuse intralobular micronodules in upper and mid lung zones with interlobular septal lines also bilateral pleural thickening was seen (A). Right middle lung zone showed hyperaeration (B). Also he had bilateral hilar, right paratracheal, prevascular and subcarinal lymphadenopathies (C). He had been working in producing sandblasted denims for 10 years. The diagnosis was based on clinical history, occupational exposure to silica dust, and chest x-ray findings after other possible diagnoses were ruled out